Tachyarrhythmia therapy device with ranked therapy selection

Abstract

A system, method, or device classifies an arrhythmia according to the temporal order in which a depolarization wave associated with a particular heart contraction is received at a plurality of electrodes. One or more antiarrhythmia therapies is mapped to each arrhythmia classification. When a particularly classified arrhythmia is detected, the correspondingly mapped therapy list is selected and an appropriate antiarrhythmia therapy delivered. In one example, the particular therapy delivered in response to an arrhythmia depends at least in part on its historical success in treating arrhythmias of that classification.

1. A cardiac rhythm management device, comprising:
 a plurality of electrodes, at least a first electrode of the plurality of electrodes configured to electrically couple to a right ventricle and at least a second electrode of the plurality of electrodes configured to electrically couple to a left ventricle; 
 an energy output circuit, coupled to the first and the second electrodes; 
 an arrhythmia detection circuit configured to detect tachyarrhythmia; and 
 a control processor coupled to the arrhythmia detection circuit and configured to select one or more electrical stimulation therapies to treat tachyarrhythmia based on a history of success of the selected one or more therapies at treating tachyarrhythmia, and to control the energy output circuit to deliver the selected one or more therapies via at least one of the first and the second electrodes; 
 wherein the control processor is configured to select the one or more therapies from available therapies based on rankings of the history of success of the selected one or more therapies and to deliver the selected one or more therapies in order of the rankings. 
 
   
   
     2. The device of  claim 1 , wherein the control processor is configured to initially deliver a first therapy having a higher ranking and to deliver a second therapy having a next higher ranking if the first therapy is unsuccessful. 
   
   
     3. The device of  claim 1 , wherein the control processor is configured to determine the rankings of the selected one or more therapies based on success of the selected one or more therapies at treating tachyarrhythmia. 
   
   
     4. A cardiac rhythm management device, comprising:
 a plurality of electrodes, at least a first electrode of the plurality of electrodes configured to electrically couple to a right ventricle and at least a second electrode of the plurality of electrodes configured to electrically couple to a left ventricle; 
 an energy output circuit, coupled to the first and the second electrodes; 
 an arrhythmia detection circuit configured to detect tachyarrhythmia; and 
 a control processor coupled to the arrhythmia detection circuit and configured to select one or more electrical stimulation therapies to treat tachyarrhythmia based on a history of success of the selected one or more therapies at treating tachyarrhythmia, and to control the energy output circuit to deliver the selected one or more therapies via the plurality of electrodes, the selected one or more therapies comprising an anti-tachycardia pacing (ATP) therapy delivered to both the right and the left ventricle via the first and second electrodes respectively; 
 wherein the history of success of the selected one or more therapies comprises an undesirability of delivering the selected one or more therapies. 
 
   
   
     5. The device of  claim 4 , wherein the undesirability of delivering the selected one or more therapies comprises pain experienced by a patient when the selected one or more therapies are delivered to the patient. 
   
   
     6. A cardiac rhythm management device, comprising:
 a plurality of electrodes, at least a first electrode of the plurality of electrodes configured to electrically couple to a right ventricle and at least a second electrode of the plurality of electrodes configured to electrically couple to a left ventricle; 
 an energy output circuit, coupled to the first and the second electrodes; 
 an arrhythmia detection circuit configured to detect tachyarrhythmia; and 
 a control processor coupled to the arrhythmia detection circuit and configured to select one or more electrical stimulation therapies to treat tachyarrhythmia based on a history of success of the selected one or more therapies at treating tachyarrhythmia, and to control the energy output circuit to deliver the selected one or more therapies via at least one of the first and the second electrodes; 
 wherein each of the selected one or more therapies comprises a plurality of therapies; and 
 wherein the plurality of therapies comprises a plurality of therapies ranked according to history of success in treating tachyarrhythmia. 
 
   
   
     7. A method for operating a cardiac device, comprising:
 detecting tachyarrhythmia; 
 selecting one or more therapies to treat tachyarrhythmia based on history of success of the selected one or more therapies, at least one of the selected one or more therapies associated with electrical stimulation delivered via a left ventricular electrode; and 
 delivering the selected one or more therapies; 
 wherein selecting the one or more therapies comprises selecting the one or more therapies based on rankings of the history of success of the selected one or more therapies; and 
 wherein delivering the selected one or more therapies comprises delivering the selected one or more therapies in order of the rankings. 
 
   
   
     8. The method of  claim 7 , further comprising modifying the rankings of the selected one or more therapies based on success of the selected one or more therapies at treating a tachyarrhythmia episode. 
   
   
     9. A cardiac device, comprising:
 means for detecting tachyarrhythmia; 
 means for selecting one or more therapies to treat the detected tachyarrhythmia based on history of success of the selected one or more therapies, at least one of the selected one or more therapies associated with electrical stimulation delivered via a left ventricular electrode; 
 means for selecting the one or more therapies based on rankings of the history of success of the selected one or more therapies; and 
 means for delivering the selected one or more therapies in order of the rankings. 
 
   
   
     10. The device of  claim 9 , further comprising means for modifying the rankings of the selected one or more therapies based on success of the selected one or more therapies at treating a tachyarrhythmia episode.